Abortion

Improving Abortion Access, Bringing Health Care Home

In California, AB 154 would increase the number of abortion providers by allowing trained certified nurse midwives, nurse practitioners, and physician assistants to provide early abortion care.

In California, AB 154 would increase the number of abortion providers by allowing trained certified nurse midwives, nurse practitioners, and physician assistants to provide early abortion care. Tiny house via Shutterstock

This piece is part of the Echoing Ida project, cross-posted with permission from Strong Families.

Each time I take a road trip down California’s magnificent highways, I can’t help but think of the dozens of people who have stayed in my home while in the Bay Area for an abortion. I pass the road signs indicating the off-ramps for Modesto, Los Banos, and Humboldt thinking fondly of the friends I made, but sad about how far they had to travel for their abortions.

For over a year, I have served as a Practical Support Volunteer for ACCESS Women’s Health Justice; I house, prepare dinners for, and give rides to people staying in the Bay Area for an abortion procedure. They come by bus, train, and sometimes car, traveling for four-to-five hours at a time, because access to abortion procedures near their hometown is lacking. They come because they didn’t realize they were pregnant until it was past the gestational limit and the clinic nearest to them couldn’t perform the abortion. They come because the time they took to thoughtfully consider all their pregnancy options meant their procedure would cost more.

They come because the clinic closest to them shares an abortion provider with several other clinics and it could be a while before they can get an appointment. They come because while they were working and saving money to pay for an abortion, they crossed a gestational threshold and now must find more money for a more expensive procedure. They scrimp and save to take off more time from work to travel for what was a one-day, but is now a two-day procedure; get someone to cover a work shift; ask someone to watch their children; and, if they’re able to, find a supportive friend or partner to join them as they travel across the state to a city they’ve never been to … all for health care.

When my friends stay in my home, we sit on the couch and talk over dinner. We talk about how far they’ve traveled, their lives back home, their beautiful children, and what the next couple of days might look like. They often ask me why they couldn’t have an abortion in their own towns, where their support people could accompany them and hold their hands, where they would be able to go home the same day and tuck their children in at night after the procedure. Until now, I didn’t have an answer for them. But now that answer is waiting for a vote and a signature. The answer is California’s Early Access to Abortion Bill.

Earlier this year, assembly member Toni Atkins (D-San Diego) introduced AB 154, a bill that would increase the number of abortion providers, by allowing trained certified nurse midwives (CNM), nurse practitioners (NP), and physician assistants (PA) to provide early abortion care. This means that more people, especially in rural areas, will be able to have access to comprehensive abortion care earlier in their pregnancies, which would help reduce the rate of complications, bring down the cost for the procedure, and allow a patient to get the care they need closer to home. Many people don’t know that almost half of the counties in California don’t have an accessible abortion provider, and 22 percent of counties don’t have a provider at all. This creates an additional hardship on those in rural areas who have to travel further for their procedures.

Recently, the University of California, San Francisco’s Bixby Center for Global Reproductive Health conducted a multi-yearlong study in which they trained and evaluated CNMs, NPs, and PAs as they performed first trimester abortions alongside the doctors performing the same procedure—the outcomes were the same. With 92 percent of abortions in the United States occurring within the first trimester, the bill would reduce barriers and increase access for the majority of people seeking abortion care. AB 154 is legislation that supports the needs of our communities.

In the United States, 6 in 10 people having an abortion are already parenting a child, while 3 in 10 have two or more children. In the evening, I often hear clients making phone calls, putting their children to bed, telling them how much they love them. “Don’t worry,” they say, “I’ll be home to put you to bed tomorrow.” Wouldn’t it be nice if they could get the care that they need and be home in time to kiss their children goodnight? Instead of having to leave their families and travel five hours for a simple medical procedure, imagine if care were provided in their own hometown. I was fortunate—my abortion provider was a 15-minute ride from my house. I felt safe knowing that I wasn’t far from my home and I would be able to rest in my bed with my family nearby soon after the procedure.

The Early Access to Abortion bill is model legislation that will put patients and families first and contribute to healthy communities.